Are hormone replacement therapy (HRT) shortages leaving you worried? We explore some more natural therapies that may help you through the menopause

The decision to take HRT is not always an easy one. While, according to The British Menopause Society, supplies are currently low – a situation exacerbated by the ongoing pandemic – the link between HRT and risk of breast cancer is more significant than previously thought.

Using data from more than 100,000 women worldwide, it was found that HRT was not only associated with an increased risk of breast cancer, but that the increased risk also persisted for more than a decade after HRT stopped.

Whilst concerned women should speak to their GP rather than stop taking HRT, Dr Marilyn Glenville PhD, a nutritionist and author of Natural Solutions to Menopause, says some dietary and lifestyle steps may help to alleviate symptoms, and that women who might not be able to get their usual prescription because of short supplies might want to think about natural alternatives. 

Hot flushes

Possibly two of the most debilitating symptoms of menopause are hot flushes and night sweats, although their severity depends upon the individual. “Certain foods and situations can trigger some hot flushes and these can include spicy foods, caffeinated drinks, alcohol and stressful situations,” says Glenville.

Some studies have found that phytoestrogens, which are naturally found in some plants, may help to reduce menopausal symptoms. “Phytoestrogens… will help cushion the effects of the hormone roller coaster as you go through the menopause,” says Glenville. “We know that women who eat a diet rich in phytoestrogens have significantly fewer hot flushes — up to half the amount experienced by women who eat very few phytoestrogens — so make sure these are included in your diet and go for variety. Contrary to popular opinion, phytoestrogens do not supply oestrogen but have a balancing effect on your hormones.”

Phytoestrogens (isoflavones), she says, work like a key. “The cells in your body have oestrogen receptors on them that act like a lock. They need a key that fits into that lock to ‘stimulate’ them into activity. This activity can be beneficial in certain places in the body like your bones and brain where you want the cells to stay active, but can be negative in other places like the breasts and womb where you do not want cells to be too stimulated, causing them to multiply and then mutate.”

Glenville says that there are two different kinds of oestrogen receptors: alpha and beta. Alpha-receptors are found in breasts, ovaries and womb. Beta-receptors are found in the brain, bones, blood vessels and bladder, and in breasts, womb and ovaries. “HRT triggers both alpha and beta-receptors, which is why it can increase the risk of breast, ovarian and womb cancer when it stimulates the cells in those areas.”

She recommends chickpeas, lentils and soya, which contain isoflavones. “Isoflavones bind to beta-receptors and stimulate beneficial effects in the brain, bone, heart and bladder. In the breast, womb and ovaries they bind to the beta-receptors and this prevents the overstimulation of the alpha-receptors and can block proliferation and prevent cancer.”

Herbal remedies 

Traditionally, herbs including sage, black cohosh, agnus castus and red clover have also been used to alleviate symptoms.

“Sage has been shown to decrease hot flushes by 50% after four weeks and by 64% after eight weeks,” says Glenville. “It also helps with decreasing insomnia, irritability, anxiety, physical and mental exhaustion by up to 47%, which can all be symptoms around the menopause. Hops have been shown to help with both hot flushes and night sweats. Red clover is one of the most extensively studied herbs and research indicates that it significantly reduces vasomotor symptoms [hot flushes] compared to a placebo.”

Blood sugar and menopause

Although keeping blood sugars balanced would benefit everyone, Glenville says that it is “absolutely crucial” during menopause, particularly if you are suffering from mood swings, irritability and depression.

She recommends eliminating added sugar and refined carbohydrates to see if that brings about an improvement in mood.

“The other important consideration is to eat little and often. This means not going more than three hours without eating. If you wait longer than this, your blood sugar will drop and the stress hormones adrenaline and cortisol will be released. It is the release of these hormones that gives rise to many of the symptoms relating to anxiety, tension, crying spells, depression and irritability.”

For aching joints, another common symptom, it is recommended to include plenty of foods with omega-3 fats, including oily fish, nuts and seeds.

Stopping hormone replacement therapy

If you are thinking of coming off HRT, speak to your GP.

Glenville says: “Stopping HRT suddenly is similar to going cold turkey and you can get withdrawal symptoms like hot flushes. It is better to take three months to gradually wean yourself off. Ask your doctor for a lower dose and if you cannot reduce the dose of the HRT, you could switch to a patch. Because the patch delivers oestrogen through the skin and does not have to be broken down by the liver first, you can get by with a lower dose than if it is taken by mouth.

“During that three month weaning process, you would then start to introduce phytoestrogens into your diet so that when you stop the HRT you are cushioned by plant oestrogens already circulating in your system.”

Other considerations

It has also been suggested that cognitive behavioural therapy (CBT) can be helpful. In one small study it was found that CBT significantly improved hot flushes, depression, sleep disturbances, and sexual concerns — although little improvement was seen in anxiety.

Exercise has also been found to be beneficial, particularly in helping mood. One study found that although it has not been shown to reduce hot flushes or night sweats, exercise can help with small improvements in insomnia, quality of sleep and mood.

Eating well, however, will have benefits post-menopause too. “Making sure that you are eating well during the menopause is not only going to help you with this transition but it will give you a really good foundation for your long term health,” says Glenville. “You can have another 30 to 50 years to live into the future and so you want to take advantage now of sowing the seeds of good health.”

If you would like more advice on nutrition and lifestyle strategies that could help you through the menopause, why not visit our Optimum Nutrition Clinic?